It allows anyone who is worried - and feels their concerns have not been sufficiently addressed - to request an urgent review by an independent, specialist clinical team.
Martha’s Rule at OUH is available in inpatient wards – including adult, children’s, neonatal, maternity and emergency department areas – across all four hospitals: the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Oxford, and the Horton General Hospital in Banbury. This also includes women and babies being cared for at Midwifery-led Units (MLUs) and at home.
The programme involves staff asking, listening, recording and acting on any changes in condition reported by patients or their loved ones.
It ensures that patients, relatives, carers and staff have access to a round-the-clock urgent review of a deteriorating patient who is currently an inpatient in OUH from an independent, specialist care team.
It improves both the quality and safety of care for patients whose condition is worsening, ensuring that concerns are listened to and acted upon if they have not been already addressed in the usual ways.
Martha’s Rule is in addition to our current escalation processes and is separate to the existing ability to request a second opinion, which is different to Martha's Rule.
When to use Martha's Rule
Inpatients or their relatives and carers (and staff looking after the patient) can call the number for Martha's Rule for an urgent review if:
they are worried about a patient’s worsening condition,
after talking to the care team, they still feel that their concerns have not been adequately addressed.
Call 0300 304 7777 and quote 'Martha's Rule call'. This is available 24 hours a day, seven days a week.
We will always ask for your consent when your number is taken, so that clinical staff can contact you and we can ask for feedback about the service you receive. Your response will be recorded securely.
You know yourself or your loved one better than anyone. You may notice small changes before they show up in our routine observations. Telling us about these changes can help us detect deterioration early, so we can take action to prevent more serious health problems.
We see you as a partner in the care we are providing. Please tell us about your concerns – we want to hear from you.
Martha's Rule is a patient safety service for an inpatient’s worsening condition. To report other clinical issues, and for other more general issues, such as food, parking or general queries, please speak to ward staff or the Patient Advice and Liaison Service (PALS).
Responding to your call
When you call, you will be asked about your concerns and where the patient is currently an inpatient.
A member of the critical care team will review the patient and provide an independent assessment.
If appropriate, this might lead to changes in treatment or a move to a higher dependency care area.
Difference between Martha's Rule and second opinions
Martha's Rule is a patient safety initiative - it is not a second opinion.
A second opinion is a request for another clinician or specialist to give their view on an ongoing diagnosis or treatment.
Please ask your doctor or nurse in charge if you wish to request a second opinion and this will be facilitated.
Martha's Rule gives our inpatients, families, carers and staff access to an urgent review if their concerns about the worsening condition of a patient is not being heard.
Background to Martha's Rule
Martha Mills died in 2021 after developing sepsis while being treated at a hospital in London, where she had been admitted with a pancreatic injury after falling off her bike.
During her stay, Martha's family's concerns about her deteriorating condition were not responded to, and in 2023 a coroner ruled that Martha would probably have survived had she been moved to intensive care earlier.
In response to this, campaigning from Martha's parents, and other cases related to the management of deterioration, the Department of Health and Social Care and NHS England agreed to implement Martha's Rule, which is designed to ensure the vitally important concerns of patients, and those who know the patient best, are listened to and acted upon.
Resources
Martha's Rule rolled out to all acute hospitals - NHS England
